Provider Demographics
NPI:1649532631
Name:CRASS, MELANIE BROOKE (PHARMD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:BROOKE
Last Name:CRASS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:BROOKE
Other - Last Name:ANGLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3030 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8607
Mailing Address - Country:US
Mailing Address - Phone:727-322-5200
Mailing Address - Fax:727-322-5288
Practice Address - Street 1:3030 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8607
Practice Address - Country:US
Practice Address - Phone:727-322-5200
Practice Address - Fax:727-322-5288
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36653183500000X
FLPS51450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist